Individual
DR. SARAT THIKKURISSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
3333 BURNET AVE, DENTISTRY ML 2006, CINCINNATI, OH 45229-3026
(513) 636-4641
(513) 636-8283
Mailing address
3333 BURNET AVE, DENTISTRY ML 2006, CINCINNATI, OH 45229-3026
(513) 636-4641
(513) 636-8283
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30.020996
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201218320
—
IN
05
—
2647667
—
OH
05
—
3810026591
—
WV
05
—
7100252000
—
KY
Enumeration date
10/04/2005
Last updated
09/19/2014
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